Table 1.

Descriptions of chief problem(s) and relevant underlying physiology and treatment options for the four high-fidelity patient simulations

SimulationChief Problem(s)Relevant Underlying PhysiologyTreatment Options
Heat exhaustionHyperthermia, hypotension1. Osmotic differences between IV fluids.Cold packs, heat blanket, 0.9% normal saline, 0.45% normal saline, 5% dextrose
2. Controlled variables (blood pressure) vs. effectors (heart rate).
Congestive heart failureHypotension, decreased cardiac contractility1. Blood pressure regulation.0.9% Normal saline, nitroprusside (vasodilator), dobutamine (β-adrenergic agonist), propranolol (β-adrenergic antagonist, epinephrine (α1-adrenergic agonist), vasopressin (vasoconstrictor, anti-diuretic hormone)
2. Cardiac mechanics.
3. Autonomic physiology.
Chronic obstructive pulmonary disease (patient has allergy to penicillin)Hypoxia1. Oxyhemoglobin dissociation curve.Albuterol (nebulized), ipratropium (anti-cholinergic, nebulized), dobutamine, propranolol, epinephrine, penicillin
2. Ventilation (pulmonary function tests).
3. Pulmonary mechanics (airway resistance and compliance).
Diabetic ketoacidosis (acute phase)Hypotension, ketoacidosis1. Blood pressure regulation.0.9% Normal saline, 0.45% normal saline, 5% dextrose, insulin, potassium, sodium bicarbonate
2. Actions of insulin.
3. Acid/base physiology.
  • Correct options are in bold.